Monday, December 10, 2012

India Cataract Medical Mission December 2012

Mat & I spent 10 days in rural India with 6 other people he knows from his business.The medical team removed cataracts from 198 indigent people. They would not have ever had the opportunity to have this surgery due to the lack of money.  We stayed & performed the surgeries at an orphanage run by Good News India. It was an incredible experience!


Here are my journal notes. 

INDIA 2012
CATARACT MISSION TRIP
Basic Facts about India
 1/6 of the worlds population
1,095,351,995  Population estimate in 2006
India is 1/3 the size of the United States.
50-60% literacy rate
60 years life expectancy

Good News India was our contact in India & our host for a medical cataract mission.
Part of the Good News India Dream Center mission is to teach Christianity and to educate the children through college or vocational school. It is to allow them to see there is more to life than field work.  The challenges to the Dream Center program is that once a girl reaches puberty she is immediately married & drops out of school. The boys feel that $1 per day is a good wage to help support their families and drop out of school.
26 Dream Center Orphanages with about 2000 children at this point.  They are located in very rural areas away from the cities.
Children are rescued from slavery, prostitution, abandonment and neglect.
One of the Dream Centers is a Leper colony. They have about 70 adult Lepers and then a multitude of children who have been disowned because they are related to a Leper.  The Leper Dream Center is the only Dream Center that has a school on premise because of the severe persecution to the children who have Leper relatives.  Two of the graduates from the Dream Center have their teaching degrees and have voluntarily returned to run this school.

The travel to our destination was incredibly long. 
Departed Monday about Noon
5 hours by airplane to East Coast
17 hours by airplane to  Mumbai
2 hours by airplane to Kolkata (Calcutta)
5 hour car ride to the Dream Center in Bangalore West Bengali
Arrived Wednesday about Noon

My initial impressions:
Traffic rules-- Our driver spoke no English. There are NO traffic rules other than the biggest thing on the narrow roads win. No blinkers are used, only horns. Our driver just laid on his horn; to pass, to say I’m behind you & want to pass, to say to the people or animals on the side of the road that I’m coming through.  Honestly it was 5 hours of solid horn blowing.  Many bicycles, many people on foot, many Tuk tuks (3 wheeled partially enclosed cab), large transit trucks and busses. We arrived quite exhausted.

Garbage is everywhere. No public trash pickup of any kind. Trash lines the roads & fields.  The people and animals just walk through the trash to get to the shops. Cows, pigs, dogs stand anywhere they want as they rummage through the trash hoping to find something worth eating.

Few if any public toilets-(The few public toilets were disgusting. Not much more than a flat drain type thing on the floor that you can squat over. There was a bucket to fill & flush the contents down the hole. There was absolutely no toilet paper to be found.  Typically a woman stands in the bathroom area hoping for a tip for allowing use of the toilet.  The majority of people and animals just stand or squat anywhere, just lift your dress or drop your drawers. It was very common to see someone “relieving themselves” anywhere.
Beautiful faces & colorful dresses.  The women dress very modestly in traditional Indian dress. They were wrapped in scarves from head to toe. The men typically wore a collared button up the front shirt but then many wore some type of scarf around their bottom half. Some wore in pants. Matching top & bottoms didn’t seem to matter.
Illiteracy rate is extremely high- None of our cataract patients could read. We began the eye exam with an eye chart but found they didn’t recognize letters. Then we drew and “E” chart but that seemed confusing to them also. We finally gave up with the eye chart.  India has 22 official languages and about 130 unofficial languages or dialects. We had several translators but even they had trouble translating for everyone.
Food- White rice is a staple. Yellow curry flavored everything. Chick peas, chicken, spinach & some veges. Chi tea, brown tortilla type bread & eggs were part of our daily fare. Nearly everything we ate was battered & deep fried.

Interesting conversations…. My job was to clean & sterilize the equipment after surgery to prepare it for the next surgery. Due to inadequate electricity our sterilizers would not operate because they pulled too much electricity & blew all fuses. So I would boil the equipment on a 2 burner gas unit on the back porch of the temporary Operating Room. One of the burners wasn’t working so we called Prusannt ( we changed his name to McGuiver because he could fix anything). As he dismantled it he said; “Somebody is in there.” A roach was in the burner. I said; “Gee I hope it is dead”. He said; “No it isn’t” & chased it out with a stick. When Mat suggested he kill it he just looked at us and said; “No it is one of God’s creatures and deserves to live also.”

--Dr Rahmen said that while abortions are legal, ultra sounds are illegal. Sons are desirable because they can provide for you when you are older. So many ultra sounds are performed in secret so female fetuses can be aborted.

WEDNESDAY- We arrived late morning. The children greeted us with song and dance. We set up and began with a few operations.

THURSDAY- we stayed busy doing surgery on about 60 patients.  
Dave, the optometrist, screened patients and determined which eye was the best choice to perform surgery on.  Michelle, the anesthesiologist, gave people blocks on the front porch.  Inside what is used as the chapel, we had set up two make shift OR tables with the microscopes and machines used to perform the surgery. Dr Dave Patel and Dr. Niel Attadaria were the ophthalmologists. Their nurses were Sarah and Robyn. Amber was the OR nurse that kept everything running smoothly.  I sat out on the back porch cleaning instruments.

FRIDAY - Today my heart was touched as I took an early morning walk through the 7 acre property that this Dream Center encompassed.
Post Op people sat in a circle in front of the building we used for our Operating Room. They were waiting for the patch to be removed from their eye. Removing the patches and allowing the people to see is rewarding. It will take up to a week before their vision is optimal. Some people immediately want their 2nd eye done. Some are not happy with the result & don’t understand it will improve. The smiles that radiated from their faces as the eye patch was removed was awesome. Many wanted to hug any and all of the medical team. They smiled brightly for the photos.  Only one patient had complications & had to be taken to the local eye hospital for further surgery.  198 cataracts were done in the time we were there.
One translator shared his gratitude with me. He stated there was no way these people could ever obtain this operation on their own because they just didn’t have the money. Due to their blindness (cataracts) they were confined to their huts. He stated that as children they were taught that Heavenly Beings have white skin. We are seen as angels to them. He was an adult before he saw his first “white” person and realized we were just another nationality. He thanked us for our service in the name of Jesus Christ.
I walked to the back of the 7 acre property Large covered pavilion area sat hundreds of old people waiting for their turn to see if their lack of sight qualified them for cataract surgery. Tarps were lined up in rows and the people sat on them while they ate their portion of rice off a leaf plate. No utensils necessary! 
Leaf plates are the industry for 6 months of the year. The leaves are gathered, sewn together & sold as disposable plates.  Another industry in the area is making rope from grasses.
I walked past the open air kitchens. Each meal is cooked over a fire. Wood must be gathered, fire built & coals prepared.  Huge bowl shaped pots were bubbling full of soupy foods for our morning meal. Many of our food items were battered & deep fried. I realized that the multiple items we were being served at each meal was unusual for the people who typically enjoy a meal of rice & chick pea curry sauce.  My repeated theme for the week was that we truly don’t understand how blessed we are.
Chi Tea was offered at least 5 times daily in small cups which contained about 1/3 c milky brown tea.
Towards the back of the property was a struggling garden with vegetables to supplement the chick pea and rice staples.  A huge fenced in area contained a few dozen rabbits, but the children refuse to eat them so they are more of just pets to observe rather than a food source.
Farm animals included rabbits, geese, chickens, a couple of cows and goats.
The back end of the property had some trees and a wash station where the children hang out their clothing after washing it.  Beyond the bamboo fence were open fields where the kids play cricket & ball games.

SATURDAY- This morning we took a walk outside of the compound. We are all so stiff from being in the same position all day & then lying on very hard beds at night.  We have been putting in very long days.
We heard about a group of 270 elephants that were in the area & we are hoping to catch a glimpse of them.  We followed elevated trails through the rice fields. It is the end of rice season. Most of the fields are bare. Rice is planted prior to the rainy season (July-Aug) then as it grows it is moved from field to field to allow it to spread out. The people work in soggy fields which breed parasites & make the people ill.
Our guide took us through a village. The homes had adobe type walls with grass thatched roofs or some had corrugated metal roofs. The walls, floors, paths & fire mounds look like smooth cement or plaster.  Each morning animal dung is collected and mixed with sand and water to create a soft plaster which is smoothed over any surface to reinforce it. This daily ritual keeps their immediate area clean & tidy. All the paths are swept clean of leaves and debris that may have fallen during the night. Leaves & twigs are either used for kindling or are edible. One specific twig is used as a toothbrush of sorts.  Each morning we saw many people standing along the road side cleaning their teeth.  Some of the huts have an electric light. We even saw one that had a satellite dish. All still cook their meals outside over an open fire.  They had many goats, some pigs, chickens, cows & one “pet” dog. Most dogs that we see are mangy looking strays.
We haven’t seen much of the children since our first day at the “Welcome Ceremony”. They have been at school or in personal & group bible study.  They meet twice daily on the top terrace of their dorm to sing and read scripture and pray.
The children attend government run schools which are not good. The older children ride their bikes 7 miles to & from school each day leaving at about 6 am.
About 6 of the older girls have been allowed to stay home to help prepare food, serve meals and wash clothing for us.  Tonight as we finished our work grabbed me by the hand and wanted me to follow.  They kept saying; “Japal, japal”…(Chapel, Chapel)  They took me to the roof top room of their dorm. About 200 kids sat crossed legged in rows on the floor with boys on one side & girls on the other. They sang songs about Jesus and also India in English and Indian, prayed & finally lined up for a piece of hard candy and a hug. After hugging 200 children and listening to them say; “thank you” or “I love you” I returned to my dorm. This is such a beautiful country with beautiful children.

SUNDAY- Every Sunday is a national holiday. It is not considered a Holy Day.  Only 2-3% of the population is Christian. There are many Muslim and Hindi people. One half of the population is not religious at all.
We went for another early morning walk but still no elephant sightings. The only evidence we saw was that they had bedded or trampled through the area. The villagers dislike the elephants because they ruin their crops and fields.
Dr Patel & his scrub nurse Robyn will only work a few hours before departing for the airport. We will be down to only Dr Attadaria then.  It may be a short day for all of us as supplies are running low. It is a domino effect where you never know what will run out or malfunction next.  Dr Rahmen (Dream Center creator) tries valiantly to find suitable replacement only to have another item malfunction or run out. He desperately wants to have us do as many cataract patients as possible.
The doctors, Patel & Attadaria say the cataracts here are extremely hardened due to years of field work in the sun. The people look at least 20 years older than they are. The average life expectancy in this area is 55-60 years. Dr. Rahmen questioned the value of giving sight to an old person as opposed to a 40-50 year old that might still be supporting a family. Future missions might try to cater to younger patients first. Those cataracts would also be less stone like.
We finished early about 5 pm. We drove to the Dream Refuge that is devoted to Lepers and children who are outcasts due to a Leper in their family.  The Lepers here are cared for, bandaged and receive tactile care. The children are cared for and educated. This Dream Center is the only one so far that has its own school. The children are treated poorly in government schools due the stigma of having a Leper family member.  A couple of “graduates” from the Dream Center orphanage that have received their teaching degrees have voluntarily returned to teach and run this school.
 Although the CAST System has been outlawed there is still huge prejudice.  I am told the CAST System is complex & difficult to explain. It contains many levels or stations according to education, employment, family, etc.

Leprosy- joint deformity, big open sores, lost digits, limbs and scaly skin. The people lose nerve feeling in their extremities and therefore don’t feel the sores. Leprosy is curable if discovered & treated early on but due to the extreme prejudice and stigma the people are hidden from the public or cast out to save face in the family.

As we greeted the adults with Leprosy they bowed & touched our feet. This apparently signifies that they recognize their station, which is lower than dirt basically. It was confusing & sad.
The children were thrilled to have visitors. They sang & danced for us then invited us to join in the dancing.  They could have danced all night.  Mat formed a Congo line & they enjoyed that. He taught a group of kids to sing “I am a Child of God”.  We finally tore ourselves away by climbing into the cars. It was a fun & rewarding day.
The children know a little English. They typically greet us with “Good Morning Auntie! “ or “Hello Auntie!”  and a big hug. They each can say the phrase; “My name is ________”. 
They have begun to feel more comfortable around us & I have a continual shadow everywhere I go. They take turns coming to my work station to watch me clean the instruments. The braver ones have dawned gloves and helped to squirt water through the instruments with syringes.  Many have watched the actual surgery with gloves & masks.  I can only believe that this is a positive educational experience for them.

MONDAY-  We have a few translators. One man is the caretaker of the Leper Dream Refuge with his wife. His English & comprehension is very good. Time can drag on for him as he sits in the OR to be ready if needed for help with a patient.  I have shared my magazines with him to help pass the time. One of the magazines boasted “Simplified Investing”. He let me know this had little interest for him. He read my Church News & Mormon Times newspapers thoroughly. Today I brought out the General Conference issue & left it on his chair. Within minutes he came & told me he needed to read this because it had many spiritual articles that he needed to share with his people.  As a spiritual leader it took no time at all for him to recognize the word of God contained in the Ensign Conference edition. I gave it to him to keep.  Once again we so very much take all that we are blessed with for granted.
We heard again that elephants were close. After dark we could hear commotion & went to the rooftop terrace to look over the valley. We could see hand held torches and lights and hear villagers banding together to heard elephants out of their villages and back into the jungle.  It was so dark that was all we could see other than a brilliantly star lite sky. 

TUESDAY- We awoke to excited voices yelling; “Haati!!” (Elephants) We ran out of the compound and into the field. One huge elephant was being herded by “herds of villagers! We followed this elephant for about a mile. It was a perfect finish for our trip.
This was our last day of surgery because we were running out of too many supplies. 198 cataracts total removed with only 1 complication which was referred to an eye hospital for further treatment.

WEDNESDAY- We packed up and relaxed.
That evening we had a “thank you” dinner with the children.

THURSDAY- We drove to Kolkata (Calcutta).  The big city was modern compared to the village we had been staying in. It had many buildings, cars and people.  The smog was just as bad from the pollution from cars, trucks & cooking fires. The sun rises and sets through a thick layer of smog and appears deep red. We shopped in one pre- arranged shop and ate lunch at a Chinese restaurant. Then we flew to New Delhi and stayed in a hotel.
FRIDAY- In New Delhi it was again a big city with many buildings. Still filthy streets jammed with people, bicycles and animals. We saw many baboon type monkeys roaming freely usually on the roof tops. They are allowed to live wherever they want and they just jump down and steal what they want.
We drove to the Taj Mahal and a Fort from its same time period & kingdom.  The Fort was built first. It’s tall walls & outer mote full of alligators protected the king and leaders.  It was made of red sandstone which resembled the Red Rocks of Southern Utah. 
Side note- there was a man with a large monkey on a leash walking through the Taj Mahal grounds. The monkey he had was a predator to the type of monkeys that roam the streets of New Delhi.  Therefore the street monkeys were afraid to come into the Taj Mahal grounds.  This man is paid well to patrol his monkey and keep the other monkeys at bay.
The story of the Taj Mahal is of a king with multiple wives. He loved one of his wives very much. Her name or title was Mahal and she bore the King 14 children before dying while giving birth to the last child. Eight of the children lived and 4 of them were sons. The King was so grieved that he built the Taj Mahal to lay his wife to rest in. It took 22 years and 100’s of artisans and workers to build this edifice.  Precious jewels and stones were gathered from the world over to inlay in this building. It is symmetrical for every angle.  Once finished he began to build a similar one across the river only it was to be black and that was where he would be buried.
The fourth son wanted the kingdom for himself & killed his older brothers. This 4th son then imprisoned his father the King in the Fort so he could reign as king. The son did allow the king to be imprisoned in a tower that had a view of the Taj Mahal.
Throughout the years the Persians have robbed and pillaged the Taj Mahal stealing the majority of the valuable jewels from the walls. However, the architecture is still beautiful.
We also visited a big Fort that was built prior to the Taj Mahal that housed the royalty. It had a huge moat with alligators & a huge wall surrounding it.  Pretty incredible when you consider they didn’t have machines.

Departed about midnight for our long trip home back to reality. 

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